Shark Attack

Emergency Management Strategies and Antimicrobial Considerations for Nonmammalian Marine Vertebrate Penetrating Trauma in North America, the Caribbean, and Hawaii: A Review Article

“…The literature search revealed 8 articles pertaining to shark-related injuries in North America and the Caribbean. 6 -13 These included 5 case reports 6,7,9,10,12 and 3 retrospective case series. 8,11,13 Treatments in all cases included wound irrigation, exploration, and debridement.…”

Shark attack-related injuries: Epidemiology and implications for plastic surgeons

“…8,16,20,24 Advancements in medical care have led to improved outcomes for shark attack victims. Plastic surgeons play a key role in the management of these patients; a heightened awareness of the circumstances of their attack and treatment of these victims may improve outcomes when this uncommon problem presents.…”

“…A shark's jaws can exert up to 18 tons per square inch of force, which enables them to bite through not only flesh, but surfboards and small boats equally. 15,16 If they survive the initial attack, victims often present to the hospital for treatment with a variety of irregular wounds that necessitate early (Table 2).…”

“…8,16 Wounds are often grossly contaminated with sand or debris and after debridement of all devitalized tissues, as with other traumatic wounds, they should either be closed over a drain or packed with dressings for delayed closure.…”

“…Patients frequently develop acute renal failure from the combination of hypovolemia, myoglobinemia, and drug toxicity. 16 Additionally, patients can require multiple transfusions and operative procedures, leading to a coagulopathy; an important consideration for reconstructive surgeons who might plan on performing free tissue transfer for wound coverage. Empiric antibiotic treatment is recommended for all shark bites.…”